Pub Date : 2021-08-31DOI: 10.6492/FJMD.202109/PP.0001
Cheng-Ying Yen, Cheng-Ming Chou, Lin-Yu Chao
Femoral neck fracture rarely occurs during the course of osteonecrosis of the femoral head (ONFH). We report a case of spontaneous bilateral femoral neck subcapital fractures in the presence of bilateral ONFH. A 30-year-old man developed bilateral hip pain while working. Plain radiographs revealed bilateral displaced subcapital fractures of the femoral neck. Magnetic resonance imaging (MRI) scans demonstrated a typical finding of bilateral ONFH. The fractures were treated with bilateral total hip arthroplasty. He had recovered satisfactorily and could return to work without any problem. ONFH rarely causes bilateral femoral neck fractures. We performed routine laboratory blood examinations and biochemical and endocrine tests, which excluded the possibility of any underlying metabolic disorders. We also performed MRI to evaluate the severity of ONFH. Fractures occurred in the subcapital area between the interface of necrotic and regenerative bone. ONFH may suddenly deteriorate to become a femoral neck fracture without head collapse or any recognizable trauma event. Although rare, bilateral hip involvement is possible. Care should be directed to the proper diagnosis and appropriate treatment of such fractures.
{"title":"Spontaneous bilateral femoral neck subcapital fractures in bilateral osteonecrosis of the femoral head: A case report and review of the literature","authors":"Cheng-Ying Yen, Cheng-Ming Chou, Lin-Yu Chao","doi":"10.6492/FJMD.202109/PP.0001","DOIUrl":"https://doi.org/10.6492/FJMD.202109/PP.0001","url":null,"abstract":"Femoral neck fracture rarely occurs during the course of osteonecrosis of the femoral head (ONFH). We report a case of spontaneous bilateral femoral neck subcapital fractures in the presence of bilateral ONFH. A 30-year-old man developed bilateral hip pain while working. Plain radiographs revealed bilateral displaced subcapital fractures of the femoral neck. Magnetic resonance imaging (MRI) scans demonstrated a typical finding of bilateral ONFH. The fractures were treated with bilateral total hip arthroplasty. He had recovered satisfactorily and could return to work without any problem. ONFH rarely causes bilateral femoral neck fractures. We performed routine laboratory blood examinations and biochemical and endocrine tests, which excluded the possibility of any underlying metabolic disorders. We also performed MRI to evaluate the severity of ONFH. Fractures occurred in the subcapital area between the interface of necrotic and regenerative bone. ONFH may suddenly deteriorate to become a femoral neck fracture without head collapse or any recognizable trauma event. Although rare, bilateral hip involvement is possible. Care should be directed to the proper diagnosis and appropriate treatment of such fractures.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"33 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76560013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.6492/FJMD.202105_12(2).0007
Hsien-Chang Huang, Shih-Chieh Yang, Y. Kao, Y. Tu
Lumbosacral defect after instrumented spinal fusion is a serious complication that challenges orthopedic surgeons. We report a case of a 63-year-old woman who underwent instrumented thoracolumbosacral correction and reconstruction surgery. Deep operative wound infection and dehiscence occurred. The wound cultures yielded Staphylococcus aureus, which was sensitive to oxacillin. After extensive debridement and negative pressure vacuum-assisted closure therapy, the soft tissue reconstruction team of our department was consulted for her irreparable lumbosacral wound defect with partial implant exposure. A pedicled superior gluteal artery perforator flap was used as a salvage procedure for lumbosacral soft tissue reconstruction. She was satisfied with the surgical results and returned to her daily activities with good recovery.
{"title":"Reconstruction of lumbosacral defect with pedicled superior gluteal artery perforator flap: A case report and literature review","authors":"Hsien-Chang Huang, Shih-Chieh Yang, Y. Kao, Y. Tu","doi":"10.6492/FJMD.202105_12(2).0007","DOIUrl":"https://doi.org/10.6492/FJMD.202105_12(2).0007","url":null,"abstract":"Lumbosacral defect after instrumented spinal fusion is a serious complication that challenges orthopedic surgeons. We report a case of a 63-year-old woman who underwent instrumented thoracolumbosacral correction and reconstruction surgery. Deep operative wound infection and dehiscence occurred. The wound cultures yielded Staphylococcus aureus, which was sensitive to oxacillin. After extensive debridement and negative pressure vacuum-assisted closure therapy, the soft tissue reconstruction team of our department was consulted for her irreparable lumbosacral wound defect with partial implant exposure. A pedicled superior gluteal artery perforator flap was used as a salvage procedure for lumbosacral soft tissue reconstruction. She was satisfied with the surgical results and returned to her daily activities with good recovery.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"227 1","pages":"85-91"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86017485","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-05-01DOI: 10.6492/FJMD.202105_12(2).0003
Lin-Mu Chen, Wen-Tien Wu, Ru-Ping Lee, Tzai-Chiu Yu, I. Chen, T. Yao, Kuan-Lin Liu, Cheng-Huan Peng, Jen-Hung Wang, Kuang-Ting Yeh
Introduction: Posttraumatic knee osteoarthritis (PTKOA) is the most common type of osteoarthritis affecting younger people's quality of life. Platelet-rich plasma (PRP) administration increases the release of growth factors that aid cartilage regeneration, providing pain relief in patients with knee osteoarthritis. Hyaluronic acid (HA) administration elicits anti-inflammatory, antinociceptive, and chondroprotective effects, as well as normalizing endogenous HA synthesis. Purpose: This paper aims to elucidate the short-term effects of combined PRP-HA injection on chronic knee pain and knee range of motion (ROM) in patients with PTKOA. Methods: Patients with a traceable history of PTKOA-related trauma and subsequent chronic knee pain were recruited retrospectively. All patients had received one combined dose of PRP-HA in the first week, followed by one weekly dose of HA alone over the following 2 weeks. Knee pain (evaluated on a visual analog scale [VAS] at rest and when walking) and knee ROM before and 6 and 24 weeks after treatment were recorded. Results: In total, 33 patients (18 men and 15 women; mean age, 50.5 ± 10.4 years; body mass index, 26.4 ± 6.5 kg/m^2) were included. Compared with those before treatment, mean VAS scores (resting and walking) significantly improved 6 weeks after treatment, and this effect persisted for another 18 weeks. Moreover, patients with Kellgren-Lawrence grade 2 osteoarthritis demonstrated better improvements in VAS scores and knee ROM than did those with Kellgren-Lawrence grade 2 osteoarthritis. Conclusion: Combined PRP and HA injections provided effective improvements in chronic knee pain and ROM in patients aged 40-65 years old with PTKOA, which persisted over 24 weeks.
{"title":"Combined injection of hyaluronic acid and platelet-rich plasma for alleviating chronic pain and improving range of motion in post-traumatic knee osteoarthritis over a short term","authors":"Lin-Mu Chen, Wen-Tien Wu, Ru-Ping Lee, Tzai-Chiu Yu, I. Chen, T. Yao, Kuan-Lin Liu, Cheng-Huan Peng, Jen-Hung Wang, Kuang-Ting Yeh","doi":"10.6492/FJMD.202105_12(2).0003","DOIUrl":"https://doi.org/10.6492/FJMD.202105_12(2).0003","url":null,"abstract":"Introduction: Posttraumatic knee osteoarthritis (PTKOA) is the most common type of osteoarthritis affecting younger people's quality of life. Platelet-rich plasma (PRP) administration increases the release of growth factors that aid cartilage regeneration, providing pain relief in patients with knee osteoarthritis. Hyaluronic acid (HA) administration elicits anti-inflammatory, antinociceptive, and chondroprotective effects, as well as normalizing endogenous HA synthesis. Purpose: This paper aims to elucidate the short-term effects of combined PRP-HA injection on chronic knee pain and knee range of motion (ROM) in patients with PTKOA. Methods: Patients with a traceable history of PTKOA-related trauma and subsequent chronic knee pain were recruited retrospectively. All patients had received one combined dose of PRP-HA in the first week, followed by one weekly dose of HA alone over the following 2 weeks. Knee pain (evaluated on a visual analog scale [VAS] at rest and when walking) and knee ROM before and 6 and 24 weeks after treatment were recorded. Results: In total, 33 patients (18 men and 15 women; mean age, 50.5 ± 10.4 years; body mass index, 26.4 ± 6.5 kg/m^2) were included. Compared with those before treatment, mean VAS scores (resting and walking) significantly improved 6 weeks after treatment, and this effect persisted for another 18 weeks. Moreover, patients with Kellgren-Lawrence grade 2 osteoarthritis demonstrated better improvements in VAS scores and knee ROM than did those with Kellgren-Lawrence grade 2 osteoarthritis. Conclusion: Combined PRP and HA injections provided effective improvements in chronic knee pain and ROM in patients aged 40-65 years old with PTKOA, which persisted over 24 weeks.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"17 1","pages":"57-62"},"PeriodicalIF":0.0,"publicationDate":"2021-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89641312","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-02-01DOI: 10.6492/FJMD.202102_12(1).0006
Pen-Yu Chung, Y. Kao, Shih-Chieh Yang, Y. Tu
We report a case of an 86-year-old woman with intractable low back and buttock pain. Radiography revealed multilevel osteoporotic vertebral compression fractures (VCFs) of the thoracolumbar spine. Magnetic resonance imaging demonstrated L2 and L3 VCFs with vacuum cleft and the incidental finding of sacral insufficiency fracture (SIF) at S1. Concomitant percutaneous vertebroplasty and sacroplasty were performed for multilevel osteoporotic VCFs and SIF in a single-stage procedure under local anesthesia. Postoperative radiography revealed good augmentation of bone cement at L2, L3, and S1. The patient was satisfied with the dramatic pain relief and good recovery of daily activities.
{"title":"Concomitant percutaneous vertebroplasty and sacroplasty for osteoporotic vertebral compression fractures and sacral insufficiency fracture: A case report and literature review","authors":"Pen-Yu Chung, Y. Kao, Shih-Chieh Yang, Y. Tu","doi":"10.6492/FJMD.202102_12(1).0006","DOIUrl":"https://doi.org/10.6492/FJMD.202102_12(1).0006","url":null,"abstract":"We report a case of an 86-year-old woman with intractable low back and buttock pain. Radiography revealed multilevel osteoporotic vertebral compression fractures (VCFs) of the thoracolumbar spine. Magnetic resonance imaging demonstrated L2 and L3 VCFs with vacuum cleft and the incidental finding of sacral insufficiency fracture (SIF) at S1. Concomitant percutaneous vertebroplasty and sacroplasty were performed for multilevel osteoporotic VCFs and SIF in a single-stage procedure under local anesthesia. Postoperative radiography revealed good augmentation of bone cement at L2, L3, and S1. The patient was satisfied with the dramatic pain relief and good recovery of daily activities.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"97 1","pages":"32-36"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76232132","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: Older adults, because of weakness in locomotion, and office workers spend most of their time in the sitting position. Kinematic analysis of the lumbar spine elucidates the causes of low back pain (LBP) while sitting, thus aiding the formulation of prevention strategies. Purpose: We investigated the difference in sagittal lumbopelvic alignment between the supine, standing, and sitting positions in middle-aged patients with chronic LBP. Methods: The lumbar lordotic (LL) angle; lumbar segmental angles, specifically L1-2, L2-3, L3-4, L4-5, and L5-S1 Cobb angles; sacral slope (SS); pelvic tilt (PT); and pelvic incidence (PI) were measured on the lateral spine in standing, supine, and sitting positions using radiographs. Results: Of the 87 participants, 47 and 40 were men and women, respectively (mean age, 56.1 ± 7.4 years). The average PI was 49.9° ± 10.0°. LL, SS, L2-3, L3-4, and L4-5 Cobb angles decreased significantly during movement from the standing to sitting position and from the standing to the supine position, while PT increased during these movements. L5-S1 Cobb angle decrease contributed the most to the change in LL when moving from the standing to sitting position. Changes in PT, LL, and L5-S1 Cobb angle when moving from the standing to the sitting position were less substantial in older participants. Conclusion: The spinopelvic sagittal parameters mostly significantly changed from the standing positions to the sitting and supine position among the middle-aged patients with chronic LBP, except for L1-2 Cobb angle and L5-S1 Cobb angle between supine and standing positions.
{"title":"Sagittal lumbar lordosis and pelvic alignment in the supine, sitting, and standing positions among the middle-aged patients","authors":"Yan-juan Chen, Chia-Yi Lee, Wen-Tien Wu, Ru-Ping Lee, I. Chen, Tzai-Chiu Yu, Kuan-Lin Liu, Cheng-Huan Peng, Minglei Chen, Jen-Hung Wang, Kuang-Ting Yeh","doi":"10.6492/FJMD.202102_12(1).0002","DOIUrl":"https://doi.org/10.6492/FJMD.202102_12(1).0002","url":null,"abstract":"Introduction: Older adults, because of weakness in locomotion, and office workers spend most of their time in the sitting position. Kinematic analysis of the lumbar spine elucidates the causes of low back pain (LBP) while sitting, thus aiding the formulation of prevention strategies. Purpose: We investigated the difference in sagittal lumbopelvic alignment between the supine, standing, and sitting positions in middle-aged patients with chronic LBP. Methods: The lumbar lordotic (LL) angle; lumbar segmental angles, specifically L1-2, L2-3, L3-4, L4-5, and L5-S1 Cobb angles; sacral slope (SS); pelvic tilt (PT); and pelvic incidence (PI) were measured on the lateral spine in standing, supine, and sitting positions using radiographs. Results: Of the 87 participants, 47 and 40 were men and women, respectively (mean age, 56.1 ± 7.4 years). The average PI was 49.9° ± 10.0°. LL, SS, L2-3, L3-4, and L4-5 Cobb angles decreased significantly during movement from the standing to sitting position and from the standing to the supine position, while PT increased during these movements. L5-S1 Cobb angle decrease contributed the most to the change in LL when moving from the standing to sitting position. Changes in PT, LL, and L5-S1 Cobb angle when moving from the standing to the sitting position were less substantial in older participants. Conclusion: The spinopelvic sagittal parameters mostly significantly changed from the standing positions to the sitting and supine position among the middle-aged patients with chronic LBP, except for L1-2 Cobb angle and L5-S1 Cobb angle between supine and standing positions.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"1 1","pages":"8-14"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89617949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Introduction: According to literature and osteoporosis treatment guidelines, both men and women with distal radius fractures (DRFx) and proximal humerus fractures (PHFx) caused by low-energy trauma may have undetected osteoporosis. Although upper limb fracture is a known predictor of subsequent osteoporotic fracture, the rates of prompt bone mineral density (BMD) evaluation and antiosteoporotic management in these patients remains much lower than those in patients with hip or spine fractures. Purpose: To evaluate the awareness of the physician for survey osteoporosis and to identify the association of the aforementioned fractures after falls with osteoporosis based on BMD estimated through dual-energy X-ray absorptiometry. Methods: We collected the parameters, including ethnicity, comorbidities, age, sex, and BMD data of the patients aged ≥ 55 years who sustained DRFx or PHFx and their BMD examination rates as physician awareness rate of possible osteoporosis. The incidence of osteoporosis among patients with these fractures was compared and associated risk factors were identified. Results: The physician awareness rates were 65.1% in DRFx and 66.0% in PHFx. Four hundred and twenty-one patients with DRFx and 219 patients with PHFx were included. Of the patients, 239 were male and 401 were female, and their mean age was 67.1 ± 6.5 years. The osteoporosis rates were 38.0% and 46.6% in DRFx and PHFx. No patient aged more than 70 years had normal BMD in our study group. Most female patients had osteoporosis, whereas most male patients had osteopenia. 7.7% of the patients had normal T scores and only 24.6% of the patients with osteoporosis were undergoing regular antiosteoporotic treatment and follow-up. Those with PHFx had a significantly higher osteoporosis risk than did those with DRFx. Conclusion: Osteoporosis awareness and treatment are crucial after distal radius or PHFx in addition to hip fractures, particularly for female and older patients.
{"title":"High prevalence of female osteoporosis and male osteopenia in patients aged more than 55 years old with upper limb fracture","authors":"Chun-Hin Lo, Yen-Yu Chen, Wen-Tien Wu, Ru-Ping Lee, Tzai-Chiu Yu, I. Chen, T. Yao, Kuan-Lin Liu, Cheng-Huan Peng, Jen-Hung Wang, Kuang-Ting Yeh","doi":"10.6492/FJMD.202102_12(1).0001","DOIUrl":"https://doi.org/10.6492/FJMD.202102_12(1).0001","url":null,"abstract":"Introduction: According to literature and osteoporosis treatment guidelines, both men and women with distal radius fractures (DRFx) and proximal humerus fractures (PHFx) caused by low-energy trauma may have undetected osteoporosis. Although upper limb fracture is a known predictor of subsequent osteoporotic fracture, the rates of prompt bone mineral density (BMD) evaluation and antiosteoporotic management in these patients remains much lower than those in patients with hip or spine fractures. Purpose: To evaluate the awareness of the physician for survey osteoporosis and to identify the association of the aforementioned fractures after falls with osteoporosis based on BMD estimated through dual-energy X-ray absorptiometry. Methods: We collected the parameters, including ethnicity, comorbidities, age, sex, and BMD data of the patients aged ≥ 55 years who sustained DRFx or PHFx and their BMD examination rates as physician awareness rate of possible osteoporosis. The incidence of osteoporosis among patients with these fractures was compared and associated risk factors were identified. Results: The physician awareness rates were 65.1% in DRFx and 66.0% in PHFx. Four hundred and twenty-one patients with DRFx and 219 patients with PHFx were included. Of the patients, 239 were male and 401 were female, and their mean age was 67.1 ± 6.5 years. The osteoporosis rates were 38.0% and 46.6% in DRFx and PHFx. No patient aged more than 70 years had normal BMD in our study group. Most female patients had osteoporosis, whereas most male patients had osteopenia. 7.7% of the patients had normal T scores and only 24.6% of the patients with osteoporosis were undergoing regular antiosteoporotic treatment and follow-up. Those with PHFx had a significantly higher osteoporosis risk than did those with DRFx. Conclusion: Osteoporosis awareness and treatment are crucial after distal radius or PHFx in addition to hip fractures, particularly for female and older patients.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"129 1","pages":"1-7"},"PeriodicalIF":0.0,"publicationDate":"2021-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79571131","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2021-01-25DOI: 10.6492/FJMD.202101/PP.0001
Takahashi Yu, Hung-Kang Wu, M. Cheng, Wei-Jei Wang, Yen-Wen Lu
Solitary plasmacytoma is a rare form of plasma cell dyscrasia. The purpose of this article is to present a case of solitary plasmacytoma involving the calcaneus, and only a few cases involving the same site have been published. The case is clinically presented with swelling and localized pain, which was initially treated as cellulitis. Image studies of X-ray, bone scan, and computed tomography found osteolytic lesions over the calcaneus. Operative tumor excision was done. The result of pathology was solitary plasmacytoma and then the patient received adequate therapeutic treatment.
{"title":"Solitary plasmacytoma in the calcaneus: A case report","authors":"Takahashi Yu, Hung-Kang Wu, M. Cheng, Wei-Jei Wang, Yen-Wen Lu","doi":"10.6492/FJMD.202101/PP.0001","DOIUrl":"https://doi.org/10.6492/FJMD.202101/PP.0001","url":null,"abstract":"Solitary plasmacytoma is a rare form of plasma cell dyscrasia. The purpose of this article is to present a case of solitary plasmacytoma involving the calcaneus, and only a few cases involving the same site have been published. The case is clinically presented with swelling and localized pain, which was initially treated as cellulitis. Image studies of X-ray, bone scan, and computed tomography found osteolytic lesions over the calcaneus. Operative tumor excision was done. The result of pathology was solitary plasmacytoma and then the patient received adequate therapeutic treatment.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86737646","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-11-01DOI: 10.6492/FJMD.202011_11(4).0004
Ju-Feng Hsueh, Karl Wu, Chih-Hung Chang
Solitary plasmacytoma of bone (SPB) was defined as solitary osteolytic bone lesion with plasma cells collection, and lack of evidence of systemic myeloma. SPB has a higher risk of multiple myeloma (MM) progression and lower survival rate compared to extramedullary plasmacytoma, which is another form of plasmacytoma with soft tissue infiltration. Most of the SPB were discovered at axial skeletons and diaphysis of long bones which red marrow is predominant. Thoracic and lumbar vertebrae are the most frequent disease distribution, while clavicle involvements were rarely seen. We reported a case of solitary plasmacytoma of proximal clavicle, an extremely rare presentation, sustained a pathologic fracture under a low-energy trauma mechanism treated with tumor excision, plate fixation, and adjuvant radiotherapy, and showed excellent stability and functional outcome in 1 year follow-up.
{"title":"Tumor of proximal clavicle-solitary plasmacytoma of bone, an extremely rare case","authors":"Ju-Feng Hsueh, Karl Wu, Chih-Hung Chang","doi":"10.6492/FJMD.202011_11(4).0004","DOIUrl":"https://doi.org/10.6492/FJMD.202011_11(4).0004","url":null,"abstract":"Solitary plasmacytoma of bone (SPB) was defined as solitary osteolytic bone lesion with plasma cells collection, and lack of evidence of systemic myeloma. SPB has a higher risk of multiple myeloma (MM) progression and lower survival rate compared to extramedullary plasmacytoma, which is another form of plasmacytoma with soft tissue infiltration. Most of the SPB were discovered at axial skeletons and diaphysis of long bones which red marrow is predominant. Thoracic and lumbar vertebrae are the most frequent disease distribution, while clavicle involvements were rarely seen. We reported a case of solitary plasmacytoma of proximal clavicle, an extremely rare presentation, sustained a pathologic fracture under a low-energy trauma mechanism treated with tumor excision, plate fixation, and adjuvant radiotherapy, and showed excellent stability and functional outcome in 1 year follow-up.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"1 1","pages":"165-169"},"PeriodicalIF":0.0,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78764460","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.6492/FJMD.202008_11(3).0003
You-Hung Cheng, Tung-Yi Lin, Ping-Yeh Chiu, Fu-Cheng Kao, M. Hsieh, Tsung-Ting Tsai, P. Lai, T. Fu, C. Niu, L. Chen
Background: Upper lumbar herniated intervertebral disc (HIVD) is clinically different from the lesion at the lower lumbar spine. Clinical symptoms in previous reports are more unspecific. Precise diagnosis and good surgical outcomes are difficult. Purpose: We aimed to investigate the clinical presentations and prognosis of upper lumbar HIVD. Methods: Data of 47 patients who were diagnosed with upper lumbar disc herniation underwent surgery from January 2000 to June 2017 in our institution were retrospectively reviewed. The lesion was at the L1-L2 level in 8 patients and L2-L3 level in 38 patients. One patient had HIVD at both levels. Clinical symptoms, patient characteristics, surgical methods, and prognosis were reviewed. Results: A total of 47 patients were followed up for a mean period of 39.3 months. The average age was 56.4 years. The major symptom in upper lumbar disc herniation was lower back and buttock pain, recorded in 30 and 5 patients, respectively. Thirty-one patients (76.6%) had pain or numbness in the anterior thigh, lateral hip, or inguinal region, which is compatible with the upper lumbar dermatome. Thirty-three patients underwent discectomy with decompression, and 11 underwent posterior instrumentation with interbody fusion. Three patients underwent nerve block as treatment. Of the patients, 76.6% had a satisfactory outcome with no major complications noted. Conclusion: The clinical presentations of upper lumbar disc herniation were usually compatible with upper lumbar level pathology. Based on history taking, physical examination, and image study, an accurate diagnosis can be achieved. Most patients had a satisfactory surgical outcome.
{"title":"Diagnosis and surgical outcome of upper lumbar herniated intervertebral disc: 47 cases from a review of 7,491 patients","authors":"You-Hung Cheng, Tung-Yi Lin, Ping-Yeh Chiu, Fu-Cheng Kao, M. Hsieh, Tsung-Ting Tsai, P. Lai, T. Fu, C. Niu, L. Chen","doi":"10.6492/FJMD.202008_11(3).0003","DOIUrl":"https://doi.org/10.6492/FJMD.202008_11(3).0003","url":null,"abstract":"Background: Upper lumbar herniated intervertebral disc (HIVD) is clinically different from the lesion at the lower lumbar spine. Clinical symptoms in previous reports are more unspecific. Precise diagnosis and good surgical outcomes are difficult. Purpose: We aimed to investigate the clinical presentations and prognosis of upper lumbar HIVD. Methods: Data of 47 patients who were diagnosed with upper lumbar disc herniation underwent surgery from January 2000 to June 2017 in our institution were retrospectively reviewed. The lesion was at the L1-L2 level in 8 patients and L2-L3 level in 38 patients. One patient had HIVD at both levels. Clinical symptoms, patient characteristics, surgical methods, and prognosis were reviewed. Results: A total of 47 patients were followed up for a mean period of 39.3 months. The average age was 56.4 years. The major symptom in upper lumbar disc herniation was lower back and buttock pain, recorded in 30 and 5 patients, respectively. Thirty-one patients (76.6%) had pain or numbness in the anterior thigh, lateral hip, or inguinal region, which is compatible with the upper lumbar dermatome. Thirty-three patients underwent discectomy with decompression, and 11 underwent posterior instrumentation with interbody fusion. Three patients underwent nerve block as treatment. Of the patients, 76.6% had a satisfactory outcome with no major complications noted. Conclusion: The clinical presentations of upper lumbar disc herniation were usually compatible with upper lumbar level pathology. Based on history taking, physical examination, and image study, an accurate diagnosis can be achieved. Most patients had a satisfactory surgical outcome.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"55 1","pages":"109-115"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80170809","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2020-08-01DOI: 10.6492/FJMD.202008_11(3).0007
Yu‐Ching Huang, Ting-Kuo Chang
Ankle fractures are among the most common fractures from orthopedic injuries. Bosworth fracture-a rare ankle fracture-occurs when the proximal fibular fragment gets impacted behind the posterior tubercle of the distal tibia. Given the rarity of the Bosworth fracture, delayed management of or neglect in reducing the entrapped proximal fibula behind the posterior tibia may lead to catastrophic complications, including compartment syndrome, early arthritic changes, and residual ankle pain. Here, we present a case of this rare type of ankle injury that was treated with immediate open reduction and internal fixation (ORIF) 6 hours after injury and review the previous literature on ankle injuries. The proximal fibula was levered out from behind the tibia with posterior traction, and the proximal fibular fragment was internally rotated gently to minimize the damage to the surrounding soft tissues. Immediate ORIF performed within 6 hours resulted in good surgical outcomes in our case.
{"title":"Bosworth fracture treated with immediate open reduction and internal fixation 6 hours after injury: A case report","authors":"Yu‐Ching Huang, Ting-Kuo Chang","doi":"10.6492/FJMD.202008_11(3).0007","DOIUrl":"https://doi.org/10.6492/FJMD.202008_11(3).0007","url":null,"abstract":"Ankle fractures are among the most common fractures from orthopedic injuries. Bosworth fracture-a rare ankle fracture-occurs when the proximal fibular fragment gets impacted behind the posterior tubercle of the distal tibia. Given the rarity of the Bosworth fracture, delayed management of or neglect in reducing the entrapped proximal fibula behind the posterior tibia may lead to catastrophic complications, including compartment syndrome, early arthritic changes, and residual ankle pain. Here, we present a case of this rare type of ankle injury that was treated with immediate open reduction and internal fixation (ORIF) 6 hours after injury and review the previous literature on ankle injuries. The proximal fibula was levered out from behind the tibia with posterior traction, and the proximal fibular fragment was internally rotated gently to minimize the damage to the surrounding soft tissues. Immediate ORIF performed within 6 hours resulted in good surgical outcomes in our case.","PeriodicalId":100551,"journal":{"name":"Formosan Journal of Musculoskeletal Disorders","volume":"23 1","pages":"136-140"},"PeriodicalIF":0.0,"publicationDate":"2020-08-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79506366","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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